Fibrinolysis of an Acute Myocarditis Mimicking an Acute Myocardial Infarction

Abstract

Background: Acute myocarditis and acute myocardial infarction have frequently similar clinical presentations and poses an important clinical challenge in the differential diagnosis. In both cases, the electrocardiographic ST-T changes and an increase in troponins can be noted. Differential diagnosis may be very challenging and requires invasive assessment of coronary arteries and other investigations especially cardiac magnetic resonance. Case Presentation: In this report, we report a rare case of acute myocarditis misdiagnosed to an acute myocardial infarction in a patient presented to the emergency department for an acute onset of chest pain with ST-segment elevation on electrocardiogram for which he received urgent fibrinolysis. The confirmation of acute myocarditis was confirmed posteriori after a normal coronary angiogram using cardiac Magnetic Resonance Imaging cMRI. Conclusions: Clinical signs as long with Electrocardiogram may mimick a ST elevation myocardial infarction in the presence of an authentic acute myocarditis,Hence, cardiac magnetic resonance could present an intersting tools to make the difference even in acute phase.